结膜入路眶隔脂肪重置对睑袋伴泪沟畸形矫正的效果观察

Efficacy of orbital septum fat repositioning through conjunctival approach in the correction of lower eyelid bags with tear trough deformity

目的观察结膜入路眶周韧带松解、眶隔脂肪瓣重置在睑袋伴泪沟畸形矫正中的效果。方法自2021年1—6月,空军军医大学第一附属医院整形外科对睑袋伴泪沟畸形的30例患者(60只眼),采用结膜入路眶周韧带松解、将中外侧眶隔脂肪作为整体形成脂肪瓣,于骨膜前间隙重置。术前及术后分别采用Barton泪沟分级系统对每只眼泪沟进行评估分级,并分析矫正效果。结果所有切口愈合良好,无血肿、感染、下睑退缩等并发症发生。48只眼术前Barton 1级,术后1个月复诊,46只眼(95.8%)为0级,2只眼(4.2%)无变化;12只眼术前Barton 2级,术后1个月,8只眼(66.7%)为0级,3只眼(25.0%)为1级,1只眼(8.3%)无变化。结论对于睑袋合并泪沟畸形,无明显下睑皮肤松弛患者,经结膜入路眶隔脂肪瓣重置是一种安全有效的矫正方法,值得临床推广应用。

Objective To observe the efficacy of orbital septum fat repositioning through conjunctival approach in the correction of lower eyelid bags with tear trough deformity.Methods From January to June 2021,30 patients with lower eyelid bags and tear trough deformity were selected.The orbital septum fat repositioning through conjunctival approach was performed.The tear trough before and after operation was evaluated by Barton’s grading system.The efficacy was analyzed.Results All incisions healed well.No complications such as hematoma,infection and lower eyelid retraction occurred.There were 48 eyes with grade 1 before operation.At 1 month after operation,46 eyes(95.8%)improved to grade 0 and 2 eyes(4.2%)did not improve.There were 12 eyes with grade 2 before operation.At 1 month after operation,8 eyes(66.7%)improved to grade 0,3 eyes(25.0%)improved to grade 1 and 1 eye(8.3%)did not improve.Conclusion For patients with lower eyelid bags,tear trough deformity and without obvious skin laxity,orbital septum fat repositioning through conjunctival approach is a safe and effective method.